Elbow, Forearm, Wrist, Hand (Therex)

The statement is true because when evaluating the elbow/wrist/hand, it is important to consider factors such as activity limits, participation restrictions, posture (head and neck), muscle tone, swelling, quality, color and temperature of the skin, quality of nails, carrying angle and rest position of the elbow, ability to use the limb, and resting position of the hand. These additional factors provide a more comprehensive assessment of the condition and function of the elbow/wrist/hand.

Epicondylitis and DeQuervain's tenosynovitis are both conditions that result from repetitive overuse of certain muscles and tendons. Epicondylitis, also known as tennis elbow, is inflammation of the tendons that attach to the bony prominence on the outside of the elbow. DeQuervain's tenosynovitis is inflammation of the tendons on the thumb side of the wrist. Both conditions are commonly seen in individuals who perform repetitive motions or activities that strain these specific areas. Therefore, it is correct to say that they are examples of overuse injuries.

DeQuervain's Tenosynovitis is a condition that occurs due to repetitive use of the hand and wrist, particularly with radial deviation (moving the wrist towards the thumb side) and the thumb stabilized in a grip. This repetitive motion can cause inflammation and irritation of the tendons in the thumb and wrist, leading to pain and swelling. Therefore, the statement that DeQuervain's Tenosynovitis is the result of overuse of hand/wrist with radial deviation and thumb stabilized in a grip is true.

The scaphoid bone is the most commonly fractured carpal bone in the wrist. It has a poor blood supply, which makes it more prone to complications with healing. Due to the limited blood flow, the fracture can lead to necrosis, which is the death of bone tissue. This can result in delayed healing or non-union of the fracture, requiring additional treatment or surgery. Therefore, scaphoid fractures often require close monitoring and specialized care to ensure proper healing.

Median nerve entrapment, also known as carpal tunnel syndrome, can cause various symptoms. Impaired sensation in the first to third digits and the lateral half of the fourth digit on the palmar aspect is one of the common symptoms. Additionally, weakness in digits one to four and a weak grip, especially with flexion, are also observed in this condition. Therefore, the given statement is true.

The radial nerve innervates extensor muscles. The radial nerve is a major nerve in the upper limb that originates from the brachial plexus and supplies motor innervation to the extensor muscles of the arm and forearm. These muscles are responsible for extending the wrist, fingers, and thumb. Therefore, the correct answer is extensor.

The given correct answer is Boutonniere deformity. This deformity is characterized by PIP flexion and DIP extension, which is consistent with the description of the damage to the extensor tendons and sheaths. The extensor hood mechanism is responsible for the normal functioning of the finger joints, and when it is damaged, it can lead to the Boutonniere deformity. Swan Neck deformity is characterized by hyperextension of the PIP joint and flexion of the DIP joint. Ulnar drift is the gradual deviation of the fingers towards the ulnar side of the hand. Dupuytren's Contracture is the thickening and contracture of the palmar fascia, resulting in the inability to fully extend the fingers.

Cubital tunnel syndrome occurs when the ulnar nerve, which runs along the inner side of the elbow, becomes compressed or entrapped. The cubital tunnel is formed by the medial epicondyle (a bony prominence on the inside of the elbow), the olecranon (the bony tip of the elbow), and the medial collateral ligament (MCL) along with a band of fibers. This compression can cause symptoms such as numbness, tingling, and weakness in the hand and fingers. Therefore, the correct answer is Cubital Tunnel syndrome.

Carpal Tunnel syndrome occurs when there is compression of the median nerve at the carpal tunnel, which is located in the wrist. This compression can be caused by inflammation of the flexor tendons and/or the median nerve itself. The condition is often associated with overuse, particularly with poor mechanics. Symptoms of carpal tunnel syndrome include pain, numbness, and tingling in the hand and fingers.

The statement is true because flexing both the elbow and shoulder joints is required to fully lengthen the triceps muscle. When the elbow is flexed, the triceps muscle is shortened, and when the shoulder is flexed, it further stretches the triceps muscle. Therefore, both movements are necessary to achieve the maximum length for the triceps muscle.

The statement is true because the hand functions best when the wrist is extended at an angle of 15 degrees. This slight extension helps to align the bones and joints of the hand, allowing for optimal range of motion and stability. It also helps to maintain a neutral position for the tendons and muscles, reducing the risk of strain or injury. Therefore, maintaining a 15 degrees wrist extension is beneficial for hand function.

Radial Tunnel syndrome is the correct answer because the statement mentions entrapment of the radial nerve at various locations in the elbow. Radial Tunnel syndrome occurs when the radial nerve is compressed or entrapped in the radial tunnel, which is a narrow space in the elbow. This can cause pain, weakness, and numbness in the forearm and hand. While it is not as common as entrapment of the median and ulnar nerves, it is still a possible condition that can occur in the elbow.

Dupuytren's Contracture is the correct answer because it matches the description provided in the question. It is a condition characterized by the contracture of the palmar fascia, causing the ring and little fingers to bend into the palm. It is more common in middle-aged men and is associated with liver disease, although the exact cause is unknown. Swan Neck deformity, Boutonniere deformity, and Ulnar drift are all different hand deformities that are not specifically mentioned in the given description.

The joints of the hand include the carpometacarpal joint, which connects the carpals (wrist bones) to the metacarpals (hand bones). The metacarpophalangeal joints are the joints between the metacarpals and the phalanges (finger bones). The proximal interphalangeal joints are the joints between the proximal and middle phalanges, while the distal interphalangeal joints are the joints between the middle and distal phalanges. Therefore, the correct answer includes all of these joints.

Ulnar drift refers to the gradual shifting of the digits towards the ulnar side of the hands at the metacarpophalangeal joints (MCPs). This condition is commonly associated with rheumatoid arthritis (RA). It is caused by the weakening and stretching of the ligaments and tendons on the ulnar side of the hand, leading to a deviation of the fingers towards the little finger. Ulnar drift is a characteristic feature of RA and can result in functional impairment and deformity of the hand.

The correct answer is Medial/ Golfer's elbow. This condition refers to the inflammation of the tendons of the Pronator teres and Flexor Carpi Radialis muscles, which are located on the inner side of the elbow. It is commonly known as Golfer's elbow because it is often caused by repetitive motions involved in golf swings. The symptoms include pain and tenderness on the inner side of the elbow, weakness in the affected arm, and difficulty in gripping or lifting objects. Treatment usually involves rest, ice, physical therapy, and in severe cases, surgery may be required.

The statement is true because the two major articulations of the wrist are indeed the Radiocarpal joint and the Midcarpal joint. The Radiocarpal joint is formed by the articulation between the radius bone of the forearm and the carpal bones of the wrist. It allows for flexion, extension, adduction, and abduction movements of the wrist. The Midcarpal joint is located between the two rows of carpal bones and allows for gliding movements between these bones. These two joints are crucial for the overall mobility and function of the wrist.

The ulnar nerve innervates flexor muscles on the ulnar side. The ulnar nerve is one of the major nerves in the arm and it provides motor innervation to the muscles that control flexion of the wrist and fingers. These flexor muscles are located on the ulnar side of the arm, which is the side closer to the pinky finger. Therefore, the correct answer is flexor.

Swan Neck deformity is characterized by hyperextension of the PIP joint and flexion of the DIP joint. This deformity is often caused by anterior capsule instability at the PIP joint, leading to PIP hyperextension and DIP flexion. Ulnar drift refers to the deviation of the fingers towards the ulnar side, while Boutonniere deformity is characterized by flexion of the PIP joint and hyperextension of the DIP joint. Dupuytren's Contracture involves the thickening and contracture of the palmar fascia, leading to flexion deformities of the fingers.

DeQuervain's tenosynovitis is the inflammation of the tendons of the Extensor Pollicis Brevis and Abductor Pollicis Longus. This condition is characterized by pain and swelling at the base of the thumb, making it difficult to move the thumb and grip objects. It is commonly caused by repetitive hand or wrist movements, such as gripping, pinching, or wringing activities. Golfer's elbow, Tennis elbow, and Carpal Tunnel Syndrome are different conditions that involve inflammation or injury to other tendons or structures in the hand and arm.

The correct answer is Humeroulnar/ Humeroradial and Proximal Radioulnar/ Distal radioulnar. These are the four articulations that involve the elbow joint. The Humeroulnar/ Humeroradial articulation refers to the joint between the humerus and the ulna, as well as the joint between the humerus and the radius. The Proximal Radioulnar/ Distal radioulnar articulation refers to the joint between the proximal end of the radius and the ulna, as well as the joint between the distal end of the radius and the ulna. These articulations allow for the movement and stability of the elbow joint.

The carrying angle and rest position of the elbow refers to the angle at which the forearm naturally rests in relation to the upper arm. A valgus angle means that the forearm deviates away from the midline of the body, while a varus angle means that the forearm deviates towards the midline. The correct answer, 15-20 degrees valgus, indicates that the forearm naturally rests at an angle that deviates away from the midline of the body by 15-20 degrees.

Colle's fx, also known as a Colles fracture, is a specific type of fracture that occurs in the distal radius, which is the bone in the forearm near the wrist. This fracture is commonly caused by a fall on an outstretched arm, making it the most likely explanation for the given scenario.

Lateral/ Tennis Elbow is the correct answer because inflammation of the tendon on Extensor Carpi Radialis Brevis is commonly referred to as Tennis Elbow. This condition typically occurs due to repetitive motions of the wrist and arm, causing pain and tenderness on the outer side of the elbow. It is not associated with Golfer's elbow, DeQuervain's tenosynovitis, or Carpal Tunnel syndrome, which involve different tendons and structures in the wrist and forearm.

The correct answer is flexor because the median nerve innervates the flexor muscles on the radial side. This means that the median nerve provides the necessary nerve signals for the flexor muscles to contract and facilitate movements such as flexion of the wrist and fingers.

The correct answer includes the symptoms of impaired sensation in digits 5 and medial half of 4 (palmar aspect) in the hyperthenar eminence, weakness of the 4th and 5th digits, particularly with flexion, and weak grip. These symptoms are indicative of ulnar nerve entrapment, which can occur when the ulnar nerve, which runs from the neck down to the hand, becomes compressed or irritated. The impaired sensation and weakness in the affected fingers and hand are common symptoms of this condition.

The correct answer suggests that the treatment for hypomobility includes heat and joint mobilization, passive prolonged stretch and heat, postural correction and strengthening of antagonist muscles, and neural gliding techniques if there is immobility of neural tissue. These interventions aim to improve joint mobility, increase flexibility, correct posture, and address any neural tissue restrictions that may be contributing to the hypomobility.

The given explanation suggests that the correct answer is "Radial Head fx" because this type of fracture is most commonly caused by a fall on an outstretched and supinated forearm, often resulting in a dislocation of the radial head. This aligns with the information provided in the question stem, indicating that the radial head fracture is the most appropriate choice among the options given.

The correct answer includes a comprehensive approach to the treatment of a fracture. Immobilization is important to ensure proper healing and prevent further damage. Isometrics ASAP (as soon as possible) refers to the use of exercises that involve muscle contractions without joint movement, which can help maintain muscle strength during the immobilization period. Adjunctive interventions such as ice and modalities can help reduce pain and inflammation. PROM/AAROM/AROM refers to different levels of mobilization exercises, depending on the stage of healing. Finally, strengthening exercises are necessary to restore dynamic function and improve overall strength after the fracture has healed.

The correct answer is a combination of the symptoms listed in the question. Entrapment of the Radial nerve can lead to impaired sensation on the posterior/radial hand and digits 1-3 (dorsal aspect), difficulty with elbow extension, and difficulty with wrist and finger extension and grip. These symptoms are indicative of Radial nerve entrapment and can help in diagnosing the condition.

The correct answer includes a comprehensive approach to treating overuse injuries. It suggests that relative rest and modalities should be used to allow the tissue to heal, and cross-fiber massage may be beneficial. The answer also emphasizes the importance of progressing through different levels of activity, starting with passive range of motion exercises and gradually incorporating resistance and functional activities. Occasional use of bracing or splinting is recommended, as well as focusing on posture, body mechanics, and ergonomics. Finally, the answer highlights the need to balance the strength and flexibility of different muscle groups, both medially and laterally, as well as anteriorly and posteriorly.

Varus and valgus instability and dislocations are classified based on the direction of movement of the radius and ulna on the humerus. Posterior dislocations are the most common and often occur from a fall on an outstretched arm, so it is advised not to reach back when falling. After reduction, the treatment starts with rest and healing and gradually progresses. Anterior dislocations are also common and often occur from a fall on an outstretched arm.

The correct answer includes several important factors for strengthening. It suggests progressing from PROM (passive range of motion) to AAROM (active assisted range of motion) to resistance and functional activities, with a focus on low load and high reps for the wrist and hand. It emphasizes the importance of posture, body mechanics, and ergonomics in promoting strength. It also highlights the significance of proximal strength for distal strength and control. Additionally, it mentions the need to balance the musculature in the medial/lateral and anterior/posterior directions.